A modified Phase I trial of radiation dose escalation in 3D conformal radiation therapy with concurrent vinorelbine and carboplatin chemotherapy for non-small-cell lung cancer

Qiang Lin, Yue'e Liu, Na Wang, Yuehua Huang, Xiaohui Ge, Xiaocang Ren, Xueji Chen, Jing Hu, Zhijun Guo, Yannan Zhao, Jun-Ichi Asaumi

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

The Radiation Therapy Oncology Group reported a maximum tolerated dose of 74 Gy for patients with non-small cell lung cancer (NSCLC); however, it was unclear whether this dose could be safely administered to Asian patients due to differences in their physique compared to Western patients. We therefore conducted a modified Phase I trial to determine whether 70 Gy could be safely delivered to Chinese patients with NSCLC undergoing 3D-conformal radiation therapy (3D-CRT) with concurrent chemotherapy. Previously untreated NSCLC patients received 3D-CRT (2 Gy/day, 5 fractions per week). Three dose levels were examined: 62, 66 and 70 Gy. Two cycles of concurrent chemotherapy (vinorelbine and carboplatin) were started on the first day of radiation therapy. Dose-limiting toxicity (DLT) was defined as severe or life-threatening side effects that altered the continued implementation of chemoradiotherapy. Among the 19 patients recruited in this study, most of the haematologic and non-haematologic toxicities were mild to moderate and clinically manageable. Only one patient, in the 70 Gy cohort, experienced a DLT of Grade 3 radiation-induced pneumonia. The overall response rate was 77.8% (14/18). The median progression-free survival (PFS) was 12 months, and the 1-year PFS was 37.6%. Our results support both the feasibility of incorporating 3D-CRT with concurrent vinorelbine and carboplatin and a dose escalation to 70 Gy for Chinese patients with NSCLC, based on the acceptable toxicity and encouraging overall response and survival rates. A further evaluation of this regimen in a prospective Phase II trial is ongoing.

Original languageEnglish
Pages (from-to)126-134
Number of pages9
JournalJournal of Radiation Research
Volume54
Issue number1
DOIs
Publication statusPublished - Jan 2013

Fingerprint

Carboplatin
chemotherapy
Non-Small Cell Lung Carcinoma
lungs
radiation therapy
Radiotherapy
cancer
Radiation
Drug Therapy
dosage
radiation
toxicity
progressions
Disease-Free Survival
Radiation Pneumonitis
pneumonia
Radiation Oncology
Maximum Tolerated Dose
vinorelbine
Chemoradiotherapy

Keywords

  • 3D conformal radiation therapy
  • concurrent chemoradiotherapy
  • dose escalation
  • non-small-cell lung cancer

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiation
  • Health, Toxicology and Mutagenesis

Cite this

A modified Phase I trial of radiation dose escalation in 3D conformal radiation therapy with concurrent vinorelbine and carboplatin chemotherapy for non-small-cell lung cancer. / Lin, Qiang; Liu, Yue'e; Wang, Na; Huang, Yuehua; Ge, Xiaohui; Ren, Xiaocang; Chen, Xueji; Hu, Jing; Guo, Zhijun; Zhao, Yannan; Asaumi, Jun-Ichi.

In: Journal of Radiation Research, Vol. 54, No. 1, 01.2013, p. 126-134.

Research output: Contribution to journalArticle

Lin, Qiang ; Liu, Yue'e ; Wang, Na ; Huang, Yuehua ; Ge, Xiaohui ; Ren, Xiaocang ; Chen, Xueji ; Hu, Jing ; Guo, Zhijun ; Zhao, Yannan ; Asaumi, Jun-Ichi. / A modified Phase I trial of radiation dose escalation in 3D conformal radiation therapy with concurrent vinorelbine and carboplatin chemotherapy for non-small-cell lung cancer. In: Journal of Radiation Research. 2013 ; Vol. 54, No. 1. pp. 126-134.
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